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CONCEPTS IN MOOD DISORDERS
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A mood is a description of one's internal emotional state. Both external and internal stimuli can trigger moods, which may be labeled as sad, happy, angry, irritable, and so on. It is normal to have a wide range of moods and to have a sense of control over one's moods.
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Patients with mood disorders (also called affective disorders) experience an abnormal range of moods and lose some level of control over them. Distress may be caused by the severity of their moods and the resulting impairment in social and occupational functioning.
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WARDS TIP
Major depressive episodes can be present in major depressive disorder, persistent depressive disorder (dysthymia), bipolar I/II disorder, and schizoaffective disorder.
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MOOD DISORDERS VERSUS MOOD EPISODES
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Mood episodes are distinct periods of time in which some abnormal mood is present. They include depression, mania, and hypomania.
Mood disorders are defined by their patterns of mood episodes. They include major depressive disorder (MDD), bipolar I disorder, bipolar II disorder, persistent depressive disorder, and cyclothymic disorder. Some may have psychotic features (delusions or hallucinations).
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WARDS TIP
When patients have delusions and hallucinations due to underlying mood disorders, they are usually mood congruent. For example, depression causes psychotic themes of paranoia and worthlessness, and mania causes psychotic themes of grandiosity and invincibility.
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Major Depressive Episode (MDE)
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Must have at least five of the following symptoms (must include either number 1 or 2) for at least a 2-week period:
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Depressed mood most of the time.
Anhedonia (loss of interest in pleasurable activities).
Change in appetite or weight (↑ or ↓).
Feelings of worthlessness or excessive guilt.
Insomnia or hypersomnia.
Diminished concentration.
Psychomotor agitation or retardation (i.e., restlessness or slowness).
Fatigue or loss of energy.
Recurrent thoughts of death or suicide.
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Symptoms must not be attributable to the effects of a substance (drug or medication) or another medical condition, and they must cause clinically significant distress or social/occupational impairment.
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KEY FACT
Symptoms of major depression—SIG E. CAPS (Prescribe Energy Capsules)
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor activity
Suicidal ideation
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A distinct period of abnormally and persistently elevated, expansive, or irritable mood, and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week (or any duration if hospitalization is necessary), and including at least three of the following (four if the mood is only irritable):
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Distractibility.
Inflated self-esteem or grandiosity.
↑ in goal-directed activity (socially, at work, or sexually) or psychomotor agitation.
↓ need for sleep.
Flight of ideas or racing thoughts.
More talkative than usual or pressured speech (rapid and uninterruptible).
Excessive involvement in pleasurable ...